MEDICARE: FRANKIE CANCEL LMHC, CASAC MASTER-G

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	012677	NY
2	101YP2500X	Professional Counselor	23546	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13-3224700	OTHER	NY	IRS
2	6570284	OTHER	NY	DOS

General Provider Information

NPI Number	:	1619473469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANKIE CANCEL LMHC, CASAC MASTER-G

Provider Business Mailing Address
First Line	:	421 8TH AVE UNIT 7375
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10116-8981
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2581 ATLANTIC AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11207-2412
Country	:	US
Telephone Number	:	718-495-0920
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2018
Last Update Date	:	01/07/2026

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